One reason for this, says Firas Rabi, MD, a pediatrician in private practice in Dublin, Ohio, is that the nicotine in cigarettes can improve attentiveness and performance. Teens and young adults with ADHD may find that nicotine enhances their attention and, in essence, use cigarette smoking as a form of self-medication. Another reason that smoking is more common is that children with ADHD often experience social difficulties and peer rejection as a result of behaviors or poor social skills. Adding insult to injury, smokers with ADHD are likely to have more severe nicotine dependence and more severe withdrawal symptoms when trying to quit.
Reducing the risk for smoking
There are no specific interventions that can be recommended to reduce the risk of smoking in children with ADHD. Treating people who have ADHD with stimulant medication could reduce their likelihood of taking up smoking, according to research from Duke Medicine in Durham, NC. Publishing their results in the journal Pediatrics, the Duke researchers found "a significant association" between stimulant treatment for ADHD and lower smoking rates. In addition, they concluded that those who took their medication consistently and for a longer period of time had an even lower risk of smoking. The findings are important given concerns raised about long-term impact of stimulant treatment on substance abuse in general and cigarette smoking in particular.
For clinicians treating patients with ADHD who are already smokers, it seems that use of stimulant medication does not have a negative impact on cessation for those interested in quitting. It is currently unclear if there is an effect on those who are not interested in quitting.
Nicotine replacement therapy seems to work equally as well for smokers with ADHD as it does for the general population.
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